Do Not USE--- Payment Election & Waiver Form Step One: Review Your Award LetterYou may always contact the Business Office directly for assistance or the Financial Aid Office if you have questions about your award letter. Step Two: Personal InformationThis information will remain private and will be erased once the data has been received by the College. Name* First Last Email* Phone*If you are an international student, include the country code with your phone number.Campus*Choose the campus to which you are enrolling or will be enrolled.Residential (McPherson Campus)Online (SPE)Step Three: Choose a Payment OptionYou can review payment options at Payment Options. Payment Options*Use the dropdown menu below to designate the Payment Options for any outstanding charges not covered by your current financial aid package.Pay in Full at Beginning of SemesterNo Balance OwedAutomatic Payment Plan529 Plan - College Savings PlanAlternative LoansParent Plus LoanVeteran/Military BenefitsUncertain- Please Contact MeFinal Step: Disclosures and PermissionsWe ask that you read and agree to each of the following statements, which outline the terms, conditions, and expectations related to payment and account management at Central Christian Colleg of Kansas. Intent to Pay* AgreeI understand that, by registering for any course or credit at Central Christian College of Kansas (the “College”) or receiving any service from Central Christian College of Kansas, I authorize the College to add to my account all tuition, fees, fines, and other charges as incurred during my association with the College. I accept full responsibility to pay all tuition, fees and other associated costs assessed as a result of my registration and/or receipt of services. Central Christian College of Kansas is providing me educational services, deferring some or all of my payment obligation for those services, and I promise to pay for all assessed tuition, fees and other associated costs by the published or assigned due date. Any and all services received by you are for educational purposes and constitute an educational loan pursuant to 11 U.S.C. § 523(a) (8) that is non-dischargeable in bankruptcy.Withdrawing & Change of Enrollment* Agree I understand and agree that, if I drop or withdraw from some or all of the classes for which I register, I will be responsible for paying all or a portion of tuition and fees in accordance with the published tuition refund schedule as outlined in the College Catalog. I also understand and agree that dropping or withdrawing from some or all of the classes for which I register may impact my financial aid as set forth in the Terms and Conditions of Financial Aid Award, which is incorporated here by reference. I also understand that modifying my schedule may result in additional fees. Billing Conditions* AgreeI accept the terms and conditions of the published tuition refund schedule and understand that those terms are incorporated herein by reference. I further understand that my failure to attend class or to receive a bill does not alter or eliminate my financial responsibility as described herein. I understand that Central Christian College of Kansas uses the Student Portal and Student email to provide billing information to me and that failure to review my e-bill does not constitute a valid reason for not paying my bill on time. I understand that administrative, clerical, or technical billing errors do not absolve me of my financial responsibility to pay the correct amount of tuition, fees, and other associated financial obligations assessed as a result of my registration at Central Christian College of Kansas.Failure to Pay* AgreeI understand and agree that, if I fail to pay my student account bill or any monies due and owing Central Christian College of Kansas by the scheduled due date, Central Christian College of Kansas may place a financial hold on my student account, preventing me from registering for future classes, requesting transcripts, or receiving my diploma and begin assessing late payment and/or finance charges at the rate outlined in the College Catalog. The College may also, at its discretion, refer my delinquent account to a collection agency. I further understand that I am responsible for paying the collection agency fee which may be based on a percentage of up to forty percent (40%) of my delinquent account, together with all costs and expenses, including reasonable attorney’s fees, necessary for the collection of my delinquent account. Any collection costs and fees stated above are charged in addition to the principal, fees and interest due on my student account. Finally, I understand that my delinquent account may be reported to one or more of the national credit bureaus. Consent* Final VerificationBy typing my name below, I attest that the information stated above is true and accurate and understand that the above information, if misrepresented or incomplete, may cause delays in processing or result in additional fees. I grant permission for any information on this form to be verified for eligibility determination.Electronic Signature* First Last CAPTCHANameThis field is for validation purposes and should be left unchanged.